Chiang Yi-Hsuan, Wang Chyong-Yau, Liu Chieh-Yu, Yang Chiu-Yueh
School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan.
Department of Nursing, Taipei City Hospital, Songde Branch, Taipei, Taiwan.
J Nurs Res. 2025 Apr 1;33(2):e383. doi: 10.1097/jnr.0000000000000665.
Prolonged depressive symptoms in individuals with schizophrenia not only diminish their quality of life but also significantly increase their risk of suicide. This, in turn, may lead to a lower average life expectancy among people with schizophrenia compared to the general population.
This study was designed to examine the effectiveness of rumination-focused cognitive behavior therapy (RFCBT) on depressive symptoms in individuals with schizophrenia.
This study was conducted between July 2019 and March 2020. Seventy-seven participants, all of whom had been diagnosed with schizophrenia, were randomly divided into the experimental group ( n = 38) and control group ( n = 39). The experimental group underwent a 12-week, six-session RFCBT regimen, whereas the control group received six sessions of psychosocial education. Outcomes were measured using the Beck Depression Inventory-II and the revised short form of the Chinese Response Style Questionnaire at three time points: baseline, postintervention, and at the 3-month follow-up. Statistical analyses were conducted using chi-square tests, independent t tests, and generalized estimating equations, with the generalized estimating equations model assessing between-group differences over time after adjusting for 13 covariates.
No effect on depressive symptoms was observed immediately following RFCBT. However, at the 3-month follow-up, the mean Beck Depression Inventory-II score had reduced significantly in the experimental group (from 17.24 to 15.56) and increased in the control group (from 17.59 to 23.03; p = .016). Chinese Response Style Questionnaire-10 scores, which are used to represent ruminative responses, did not differ significantly between the groups at any of the three time points.
CONCLUSIONS/IMPLICATIONS FOR PRACTICE: These findings offer compelling preliminary evidence in support of RFCBT as a potentially effective treatment strategy for alleviating depressive symptoms in patients with schizophrenia. The efficacy of RFCBT was demonstrated in terms of preventing the exacerbation of depressive symptoms. The findings have notable implications for clinicians, researchers, and policymakers with regard to developing more effective treatment strategies and enhancing outcomes for individuals with schizophrenia.
精神分裂症患者长期存在的抑郁症状不仅会降低他们的生活质量，还会显著增加其自杀风险。这反过来可能导致精神分裂症患者的平均预期寿命低于普通人群。
本研究旨在探讨以沉思为重点的认知行为疗法（RFCBT）对精神分裂症患者抑郁症状的疗效。
本研究于2019年7月至2020年3月进行。77名均被诊断为精神分裂症的参与者被随机分为实验组（n = 38）和对照组（n = 39）。实验组接受为期12周、共6节的RFCBT疗程，而对照组接受6节心理社会教育课程。在三个时间点使用贝克抑郁量表第二版和修订后的中文版反应方式问卷简表测量结果：基线、干预后和3个月随访时。使用卡方检验、独立t检验和广义估计方程进行统计分析，广义估计方程模型在调整13个协变量后评估组间随时间的差异。
RFCBT后立即未观察到对抑郁症状有影响。然而，在3个月随访时，实验组的贝克抑郁量表第二版平均得分显著降低（从17.24降至15.56），而对照组得分升高（从17.59升至23.03；p = 0.016）。用于表示沉思反应的中文版反应方式问卷-10得分在三个时间点的任何一个时间点组间均无显著差异。
结论/对实践的启示：这些发现提供了令人信服的初步证据，支持RFCBT作为缓解精神分裂症患者抑郁症状的一种潜在有效治疗策略。RFCBT的疗效体现在预防抑郁症状的加重方面。这些发现对于临床医生、研究人员和政策制定者在制定更有效的治疗策略和改善精神分裂症患者的治疗效果方面具有显著意义。
